It's not unusual for someone with psoriasis to also have psoriatic arthritis, which comes with symptoms of stiffness, pain, and swelling. Find out how one man manages both conditions.

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Like many people with psoriasis, Richard Seiden,
61, an attorney and chair of the National Psoriasis Foundation board of trustees,
also has psoriatic
arthritis. In Seiden’s case, psoriasis was diagnosed first, before
the onset of psoriatic arthritis symptoms.

His psoriasis diagnosis at age 22 came as a
surprise. “I had scaling on my scalp and I thought it was dandruff,” he says.
“I went to see a dermatologist and he diagnosed it as psoriasis and sent me
home with coal tar.” He remembers also getting some ultraviolet
light psoriasis treatment on his arms. “My reaction to the diagnosis
was matter-of-fact acceptance,” says Seiden. “I thought, ‘I have a condition I
have to treat.’”

The
Shock of Psoriatic Arthritis

Four years later, Seiden was again surprised when
he was diagnosed with psoriatic arthritis. “I had played basketball and
football regularly all through high school and college, and after law school, I
decided to take up tennis. I got good enough to make a local team —
that’s when my left knee imploded and blew up like a balloon.”

Seiden went to see a physical therapist, who sent
him to a rheumatologist. The rheumatologist diagnosed Seiden with
trauma-induced psoriatic arthritis. “I didn’t know that psoriasis could be accompanied
by arthritis, and I didn’t expect to have arthritis at the age of 26.”

At the time, his reaction to the psoriatic
arthritis diagnosis was actually a relief. “I had thought it was an orthopedic
problem and I was grateful to know that I didn’t need surgery,” says Seiden. “I
knew very little about the condition, or how severe my case would become.”

Up to 30 percent of people with psoriasis also
develop psoriatic arthritis. Psoriatic arthritis symptoms can include
stiffness, pain, and swelling in and around the joints. General psoriasis
treatment and medication can have some effect on psoriatic arthritis,
but some patients may need specific treatments for psoriatic arthritis, such as
injections into the joints or surgery.

Support
for Psoriasis Symptoms

When he told his mother about the initial scalp
psoriasis diagnosis, Seiden learned that she, too, had psoriasis — on
her elbows. “I hadn’t known this,” he says. “When I first met my wife-to-be, I
let her know that the red patches on my chest and arms were psoriasis and that
it wasn’t contagious. She was fine with this, and accepting of my condition.”

Although Seiden prides himself on his
self-sufficiency, his family and friends have given him emotional and physical
assistance when necessary. “Over time, the degradation of my joints has left me
with less physical strength, and family and friends and co-workers regularly
volunteer to assist me,” says Seiden. “I’ve had two knee replacements, and my
family played a major role in my recovery and rehabilitation, helping me up
from a chair, dressing, and things like that.”

Seiden’s psoriasis medication helps, too. He
receives corticosteroid injections for the occasional lesion, and he reports
that those treatments also help his arthritic symptoms. Similarly, when he gets
a corticosteroid injection in a joint for the occasional flare, that helps his
skin disorder.

"Both are inflammatory diseases, both are
autoimmune disorders," says Seiden, who prefers conventional to
complementary and alternative treatments. "There is some evidence that if
you control the symptoms of one, then it benefits the other."

Overcoming
the Challenges of Psoriatic Arthritis

For Seiden, the biggest challenge is knowing that
psoriatic arthritis is a chronic condition that involves ever-present pain. He
experiences flares in his joints, and his fine motor skills are impaired.
“Tying a tie, tying a shoe, the top button of a button-down collar shirt
— these can be a problem. Once, while traveling on a business trip, I
had to request the assistance of the hotel concierge to button the top button
of my shirt, tie my tie, and then at the end of my dinner, reverse it all,”
says Seiden, adding, “I’m grateful that we have moved away from business suits
to business casual.”

Putting
Psoriatic Arthritis in Perspective

“When my son was young, I couldn’t throw a ball
overhand to him. And I miss playing tennis, which meant something to me,” says
Seiden.

Seiden’s secret to living with psoriatic arthritis
is to keep busy with work and social activities. “I accept that I have
psoriasis, but I don’t accept that it controls me. You have to find ways to
overcome the pain by redirecting your energy into positive channels. I remain
focused on my work and volunteer efforts, go to events and plays, musicals, and
movies, and do crossword puzzles. I enjoy spending quality time with my
family.”

“Every day has its challenges and constraints, but
this is only a small part of who I am,” Seiden says. “I derive great personal
satisfaction from helping others to help themselves.”

Like so many people with psoriasis, Seiden wants
others to understand more about the condition — especially that it is
not contagious. He tells heartbreaking stories about kids who want to withdraw
from public because they've been accused of having AIDS or leprosy. "I've
gone to Capitol Hill and met with public officials who asked if it's okay to
shake my hand," says Seiden. "We need education.”

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